Craniocervical deformity and myelopathy after chronic odontoid fracture

Shamji, Mohammed F.; Fehlings, Michael G.

doi:10.1503/cmaj.140877

Cited by 1 publication

(3 citation statements)

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“…[13][14][15][16] There are different methods to measure the inclination angle of the articular surfaces of LAJs in patients with atlantooccipital fusion, but these methods are not suitable in patients with odontoid fractures due to the influence of atlantooccipital joints. 14,17 Therefore, we proposed a new method to measure the inclination angle in this study. The selected reference lines are on the atlas and are not affected by the atlantooccipital joints.…”

Section: Discussionmentioning

confidence: 99%

“…At this stage, some patients showed abnormal kyphosis of the occipitoaxial segment, and the lower cervical spine showed compensatory lordosis. The cervical spine forms the so-called swan neck deformity 17,18 (Figure 5A-I). With the collapse of the LAJs and the forward and downward movement of C1 relative to C2, the vertical distance between C1 and C2 is shortened.…”

Section: Discussionmentioning

confidence: 99%

“…The inclination angle of the articular surfaces of LAJs is a commonly used parameter to evaluate morphological changes of LAJs 13–16 . There are different methods to measure the inclination angle of the articular surfaces of LAJs in patients with atlantooccipital fusion, but these methods are not suitable in patients with odontoid fractures due to the influence of atlantooccipital joints 14,17 . Therefore, we proposed a new method to measure the inclination angle in this study.…”

Section: Discussionmentioning

confidence: 99%

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Morphometric Analysis of the Lateral Atlantoaxial Joints in Patients with an Old Type II Odontoid Fracture and Atlantoaxial Dislocation

Liao

Tang

et al. 2020

Spine

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Study Design. Retrospective cohort study.Objective. We aimed to study and interpret the morphological features of the lateral atlantoaxial joints (LAJs) in patients with old type II odontoid fractures and atlantoaxial dislocation (AAD). Summary of Background Data. The causes and consequences of the morphological changes of the LAJs in patients with old type II odontoid fractures and AAD have not been analyzed before. Methods. A retrospective study was performed on patients with old type II odontoid fracture and AAD. These patients were placed in group A (unstable or reducible dislocation) or group B (irreducible or bony dislocation) depending on the type of dislocation they had. We documented the morphological changes and measured the inclination angle of the articular surface of the LAJs in computerized tomographic images and compared the results collected for the two groups. The association between the history of injury and the inclination angle of the articular surface of the LAJs was assessed using the Pearson correlation coefficient. Results. A total of 29 patients were enrolled (16 patients in group A, and 13 patients in group B). The inclination angle in group A was significantly greater than that in group B (P < 0.001). Patients in group B were more likely to have fish-lip-like changes, dome-like changes, or collapse of the LAJs. Age, history, atlantodental interval, and Japanese Orthopedic Association score were also significant differences between the two groups (P < 0.05). There was a negative correlation between the history of injury and the inclination angle of the articular surfaces of the LAJs (left: r ¼ À0.726, P < 0.001; right: r ¼ À0.795, P < 0.001). Conclusion. The morphological changes of the LAJs could progressively become more pronounced during the evolution of the disease.

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